CARC 257PI · Payer Initiated
Final payment for this claim is pending further review of reasonable and customary fee determinations under the service agreement.
- Common causes
- The payer is still evaluating an appropriate reimbursement amount against its fee benchmarks.
- Suggested fix
- Follow up with the payer after their standard review period for a final determination.
Related Payer Initiated codes
Frequently asked questions
What does CARC 257 mean?
Final payment for this claim is pending further review of reasonable and customary fee determinations under the service agreement.
How do I resolve CARC 257?
Follow up with the payer after their standard review period for a final determination.
Why does CARC 257 happen?
The payer is still evaluating an appropriate reimbursement amount against its fee benchmarks.
CARC codes maintained by X12 (x12.org). Descriptions on this site are original reference interpretations. Always verify codes with authoritative sources before making billing decisions.